Elias Sjoerd G, Peeters Petra H M, Grobbee Diederick E, van Noord Paulus A H
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
J Natl Cancer Inst. 2004 Apr 7;96(7):539-46. doi: 10.1093/jnci/djh087.
Data from animal models suggest that caloric restriction may reduce the risk of breast cancer, although not all dietary regimens produce similar effects. We examined whether caloric restriction imposed as a consequence of the 1944-1945 Dutch famine reduced the risk of breast cancer in women participating in a Dutch breast cancer screening program.
Between 1983 and 1986, approximately 15 000 women, aged 2 to 33 years during the 1944-1945 Dutch famine, responded to a questionnaire about their famine experience. A famine exposure score, graded as absent, moderate, or severe exposure, was derived from answers regarding hunger, cold, and weight loss. During follow-up until January 2000, 585 women with incident breast cancer were identified by the regional cancer registry. The relationship between famine exposure and breast cancer risk was assessed by weighted Cox regression models, in which person-years lived for the entire cohort was extrapolated from data from a random sample of 15% of the cohort.
Women who were severely exposed to the famine had a statistically significantly higher risk of breast cancer (hazard ratio [HR] = 1.48, 95% confidence interval [CI] = 1.09 to 2.01) than women who were not exposed. Women who were moderately exposed to the famine had a 13% increased risk of breast cancer (HR = 1.13, 95% CI = 0.92 to 1.38; P(trend) = 0.016). The association between famine exposure and breast cancer risk was stronger for women who were exposed between the ages of 2 and 9 years (severely exposed versus unexposed: HR = 2.01, 95% CI = 0.92 to 4.41) than for women who were exposed at older ages.
The risk of breast cancer was increased in women who were severely exposed to a short but severe famine decades earlier. This result is compatible with data from the few animal studies investigating effects of short-term, transient caloric restriction.
动物模型数据表明，热量限制可能会降低患乳腺癌的风险，尽管并非所有饮食方案都能产生类似效果。我们研究了1944 - 1945年荷兰饥荒导致的热量限制是否降低了参与荷兰乳腺癌筛查项目的女性患乳腺癌的风险。
1983年至1986年期间，约15000名在1944 - 1945年荷兰饥荒期间年龄在2至33岁的女性回答了一份关于她们饥荒经历的问卷。根据关于饥饿、寒冷和体重减轻的回答得出饥荒暴露评分，分为无暴露、中度暴露或重度暴露。在随访至2000年1月期间，区域癌症登记处识别出585例新发乳腺癌女性。通过加权Cox回归模型评估饥荒暴露与乳腺癌风险之间的关系，其中整个队列的人年数是根据队列中15%的随机样本数据外推得出的。
与未暴露的女性相比，重度暴露于饥荒的女性患乳腺癌的风险在统计学上显著更高（风险比[HR]=1.48，95%置信区间[CI]=1.09至2.01）。中度暴露于饥荒的女性患乳腺癌的风险增加了13%（HR = 1.13，95% CI = 0.92至1.38；P（趋势）= 0.016）。2至9岁暴露的女性中，饥荒暴露与乳腺癌风险之间的关联比年龄较大时暴露的女性更强（重度暴露与未暴露相比：HR = 2.01，95% CI = 0.92至4.41）。
几十年前严重暴露于短期但严重饥荒的女性患乳腺癌的风险增加。这一结果与少数研究短期、短暂热量限制影响的动物研究数据一致。
